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Idaho rates for HCPCS 22869

Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,628.00 / $4,500.00 / $7,205.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,058.47 / $13,058.47 / $13,095.19
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$399.55 / $717.59 / $1,085.63
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23,890.63 / $35,236.89 / $43,515.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,600.00 / $11,800.00 / $29,092.00